| NPI | 1760435416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 037523) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-0169) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN DO01244) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2015-01-14 |